At a Glance

Why Get Tested?

To determine if you have sufficient rubella antibodies to protect you from the rubella virus; to verify a past infection or detect a recent infection

When to Get Tested?

Prior to or at the beginning of a pregnancy to verify immunity; when a pregnant woman has symptoms of rubella, such as fever and rash; when a newborn shows signs of abnormal development or birth defects that may be caused by an in uteroinfection; whenever there is need to verify a recent rubella infection or to verify immunity

Sample Required?

A blood sample drawn from a vein in the arm of an adult or blood drawn from a heelprick or from the umbilical cord of a newborn

Test Preparation Needed?

None

The Test Sample

What is being tested?

Rubella is a virus that causes an infection that is usually mild and characterized by fever and rash that last about 2 to 3 days. The Infection is highly contagious but is preventable with a vaccine. This test detects and measures rubella antibodies in the blood that are produced by the body's immune system in response to an infection by the rubella virus.

There are two types of rubella antibodies: IgM and IgG. The first type to appear in the blood after exposure is the IgM rubella antibody. The level of this protein rises and peaks in the blood within about 7 to 10 days after infection and then tapers off over the next few weeks, except in an infected newborn, where it may be detected for several months to a year. The IgG rubella antibody takes a bit longer to appear than the IgM, but once it does, it stays in the bloodstream for life, providing protection against re-infection. The presence of IgM rubella antibodies in the blood indicates a recent infection while the presence of IgG antibodies may indicate a recent or past rubella infection, or indicate that a rubella vaccine (a measles, mumps, rubella vaccine) has been given and is providing adequate protection.

The rubella virus generally causes a mild infection marked by a fine red rash that appears on the face and neck and then travels to the trunk and limbs before disappearing a few days later. The virus is passed through nasal and throat secretions and can cause symptoms such as fever, enlarged lymph nodes, runny nose, red eyes, and joint pain. Symptoms may be so minimal, especially in children, that they are not perceived as being from a viral illness. In most people, rubella goes away within a couple of days without any special medical treatment and causes no further health issues.

The primary concern with rubella infection is when a pregnant woman contracts it for the first time during the first three months of her pregnancy. The developing fetus is most vulnerable to the virus at this time and, if it is passed on to the fetus by the mother, it can cause miscarriage, stillbirth, and/or congenital rubella syndrome (CRS), a group of serious birth defects that will permanently affect the child. CRS can cause delayed development, mental retardation, deafness, cataracts, an abnormally small head, liver problems, and heart defects.

Because of the severe consequences for developing fetuses, a national campaign was started in 1969 to immunize all children in the United States and to work to eradicate rubella infection, first in the U.S. and then throughout the world. Prior to this time, rubella infections would emerge as cyclic outbreaks that lasted for several years. According to the Centers for Disease Control and Prevention (CDC), during the 1962-1965 rubella epidemic, 12.5 million cases of rubella occurred in the United States and there were 20,000 infants born with CRS. Due to vaccination efforts, these numbers have decreased drastically. The latest statistics from the CDC, from 2008, show that there were only 16 cases of rubella recorded in the United States. Each year since 2001, there have been fewer than 25 cases reported. The CDC now declares endemic rubella to be eradicated in the U.S., although the incidence continues to be monitored. People should not become complacent with this reduction, however, and the CDC cautions people to continue to have their children vaccinated. Anyone who has not received the vaccination as a child (and a few that have) may still be vulnerable to rubella infection.

Pregnant women and women considering pregnancy continue to be routinely tested for rubella antibodies to ensure that they have sufficient levels for immunity.

How is the sample collected for testing?

A blood sample is drawn from a vein in the arm of an adult or from a heelprick or the umbilical cord of a newborn.

Is any test preparation needed to ensure the quality of the sample?

The Test

How is it used?

Confirm the presence of adequate protection against the rubella virus (immunity)

Detect a recent or past infection

Identify those who have never been exposed to the virus and those who have not been vaccinated

Verify that all pregnant women and those planning to become pregnant have a sufficient amount (titer) of rubella antibodies to protect them from infection

A rubella test may be ordered on a person, pregnant or not, who has symptoms that the doctor suspects are due to a rubella infection. It may also be ordered on a newborn who is suspected to have become infected during pregnancy or that presents with congenital birth defects that the doctor suspects may be due to a rubella infection.

When is it ordered?

The IgG rubella test is ordered when a woman is pregnant or is planning on becoming pregnant. It is ordered whenever a check of immunity against rubella is required. IgM and IgG rubella tests are ordered when a pregnant woman has signs and symptoms that may indicate a rubella infection.

Some signs and symptoms include:

Mild fever

A pink rash that begins on the face and then spreads downward to the body and then the legs and arms; once it begins to spread to the body, the rash may disappear from the face.

Since many conditions can cause similar symptoms, the doctor will need to order the tests in order to confirm the diagnosis.

IgM and IgG tests may be ordered on a newborn when the mother was diagnosed with a rubella infection during pregnancy and/or when a newborn is born with birth defects such as hearing loss, cardiovascular abnormalities, cataracts, and/or central nervous system disease that could be due to CRS.

Since IgM and IgG rubella antibodies take some time to appear after infection, the tests may be repeated in 2 to 3 weeks to see if the antibody levels have become detectible (when initially absent) and to determine whether the levels are rising or falling over time.

This test may be required of a health care worker or a person starting college and is still ordered on women in some states as part of the blood testing required to obtain a marriage license.

What does the test result mean?

In an adult or child, the absence of IgG rubella antibodies means that the person likely has not been exposed to the rubella virus or been vaccinated and is not protected against it. The presence of IgG antibodies but not IgM antibodies indicates a history of past exposure to the virus or vaccination and indicates that the person tested should be immune to the rubella virus. The presence of IgG antibodies, but not IgM antibodies, in a newborn means that the mother's IgG antibodies have passed to the baby in utero and these antibodies may protect the infant from rubella infection during the initial six months of life. The presence of IgM antibodies in a newborn indicates that the baby was infected during pregnancy because the mother’s IgM antibodies do not pass to the baby through the umbilical cord. The presence of IgM antibodies, with or without IgG antibodies, in a child or adult indicates a recent infection with the rubella virus.

Occasionally, a person may have a false positive test for IgM rubella antibodies because the test components cross react with other proteins in their body. To confirm the IgM result, the doctor may order an IgG test to establish a baseline level of antibody and may repeat the IgG test again in 2-3 weeks to look for a significant increase in the amount (titer) present, indicating a recent rubella infection.

Is there anything else I should know?

It is possible to test for the genetic material (RNA) of the rubella virus directly in a sample or culture a body fluid sample, such as a throat swab. The rubella virus takes at least a week or more to be detected in culture, and special molecular assays or specifically prepared antibodies must be used to determine if the virus is present. This may occasionally be done to help a doctor diagnose rubella infection in a newborn. Because this procedure is complex and expensive, most diagnostic laboratories refer this testing to a reference lab such as the Centers for Disease Control and Prevention (CDC).

The number of cases of rubella and congenital rubella is monitored by the CDC to track the effectiveness of the rubella vaccine and to detect any outbreaks of the disease.

1. Should pregnant women be vaccinated for rubella?

2. Does the vaccine have any risks?

The vaccine contains a live virus that has been altered so it promotes an antibody response but does not cause a rubella infection. Some people may have a rash that lasts 2–3 weeks after vaccination and pain in their joints, especially their hands and wrists. Side effects are rarely seen in young children who get the vaccine. People who have suppressed immune systems, such as those with HIV/AIDS and those with cancer who are undergoing chemotherapy, should consult with their doctors before getting a rubella vaccine.

3. How soon after I have been exposed to the virus will I get it?

If you are going to have symptoms, the rash usually begins 15–17 days after coming in contact with an infectious person, but it may take as long as 3 weeks. A person is usually infectious about a week before the rash is visible and for 1-2 weeks afterwards. A newborn who was infected during pregnancy may remain infectious for several months.

4. What do the letters in the MMR vaccine stand for?

Measles, Mumps, and Rubella. Since all three of these are common viral illnesses, they are contained within one vaccine. Measles is also known as Rubeola and is different from Rubella (German Measles).

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Article Sources

NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used for Current Review

Centers for Disease Control and Prevention. Travelers’ Health, Chapter 3 Infectious Diseases Related To Travel, Rubella. Available online at http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/rubella.htm through http://wwwnc.cdc.gov. Accessed October 2011.

(Updated 2011 January 3). Rubella: Make Sure Your Child Is Fully Immunized. Centers for Disease Control and Prevention [On-line information]. Available online at http://www.cdc.gov/features/rubella/ through http://www.cdc.gov. Accessed October 2011.

(February 18, 2011) Centers for Disease Control and Prevention. FastStats, Measles Morbidity. Available online at http://www.cdc.gov/nchs/fastats/measles.htm through http://www.cdc.gov. Accessed October 2011.

(Updated May 2007) Centers for Disease Control and Prevention. Guidelines for Vaccinating Pregnant Women. Available online at http://www.cdc.gov/vaccines/pubs/preg-guide.htm#rubella through http://www.cdc.gov. Accessed online April 2008.

Centers for Disease Control and Prevention. MMWR (March 21, 2008) 51(53). Summary of Notifiable Diseases - United States 2006. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5553a1.htm through http://www.cdc.gov. Accessed online April 2008.

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This article was last reviewed on October 27, 2011. | This article was last modified on February 24, 2015.

The review date indicates when the article was last reviewed from beginning to end to ensure that it reflects the most current science. A review may not require any modifications to the article, so the two dates may not always agree.

The modified date indicates that one or more changes were made to the article. Such changes may or may not result from a full review of the article, so the two dates may not always agree.